Treatment of Acne Vulgaris with 5-Alpha Avocuta Cream 2% in Comparison with Tretinion Cream 0.025% (Single Blind Comparative Study)

Background: Acne vulgaris is a common skin disease. Its pathogenesis is multifactorial, and therapy can now be directed at many of these factors. Among these factors are androgen hormones which play an important role in the pathogenesis of acne. Accordingly, many antiandrogens have been developed to treat acne by systemic and topical ways. Five-Alpha Avocuta 2% cream is a new topical 5-Alpha reductase inhibitor extracted from the tropical fruit “avocado”. Objectives: To evaluate the effectiveness and safety of 5-Alpha Avocuta cream and compare it to tretinoin 0.025% cream, in the treatment of acne vulgaris. Patients & Methods: This single blinded comparative study was done in Department of Dermatology—Baghdad Teaching Hospital, from July 2009 through October 2010. All demographic points related to the disease were obtained from each patient to evaluate severity of acne. Sixty-eight patients with acne were divided into two groups and instructed to apply the drugs for three months. Group A uses 5-Alpha Avocuta 2% (Teen-derm K) cream and Group B uses tretinoin (Acretin) 0.025% cream. Severe acne was excluded from the study. The clinical improvement was evaluated by counting the number of inflammatory lesions before and after treatment and compare between them by paired t-test. Results: Fifty-eight patients completed the study, their age ranged from 12 30 years with a mean of 18.21 ± 4.64 years. In Group A there was a significant reduction of the mean number of papules from 29.7 before treatment to 15.5 after treatment (p < 0.0001), while the mean number of pustules decreased from 4.9 to 0.6 (p = 0.019). In Group B the mean number of papules was reduced from 28.5 to 14.9 (p < 0.0001), while the mean number of pustules dropped from 5.3 before treatment to 0.7 after treatment (p = 0.009). The mean difference of papules after 14 weeks in Group A was 15.55 ± 6.95 while in Group B, the mean difference was 14.86 ± 6.99. This result was statistically not significant (p = 0.708, t-test). The difference in the mean percentage of reduction of inflammatory lesions at week 14 between the two groups was not statistically significant (p-value = 0.999).The side effect was negligible in Group A and not required stopping the drug while in Group B treatment stopped in 2 patients. Conclusions: 5-Alpha Avocuta was an effective mode of therapy in treatment of acne vulgaris, and it was comparable to tretinoin, with little side effects.